“Critical Care is not a geographic location like the ICU of a hospital. Critical care is a set of knowledge and skills that a doctor carries with them. And nurses too!”
_Joe Niemczura, CCNEPal
A.C.L.S. (or just plain ACLS) is Advanced Cardiac Life Support. The abbreviation denotes a two-day course in critical care skills in USA, leading to a certificate. ACLS is only just now becoming more widely known in Nepal. Note: be sure to click on the hyperlinks, in blue.
A Mandatory requirement in USA
ACLS was developed decades ago by the American Heart Association (AHA) and in USA it is a required course for any doctor or nurse who works in O.T., Casualty, post-op, or critical care. In a USA hospital, no doctor or nurse is allowed to administer midazolam unless they have had this course, because this drug produces “conscious sedation.” In USA, most medical students take an ACLS course during their senior year, and it is required before starting any residency program.
ACLS is a two-day course, but most people who take it for the first time will prepare by taking an ecg course, an airway course, a Basic Life Support (BLS) course, and a pharmacology course. ACLS is not simply a sit-down-and-take-notes class; it involves simulated patient situations that teach you how to react and save a life. ACLS gives assessment skills and teamwork skills that apply to a wide variety of situations.
Because of the reliance on high standards of instruction, the AHA has a stringent set of requirements for anybody who proposes to teach the course leading to the “official” certification. These are laid out in a 60-page Program Administration Manual. Until very recently, the only way a person from Nepal could take this course was a) travel to Delhi and enroll there; b) enroll in a course brought into Nepal by various groups of videshi doctors who bring the equipment with them; or c) take an unofficial version of the course.
The difficulty and expense of enrolling in a course has led to a sort of secrecy about the training, in which it becomes mysterious and limited to a few persons. The problem is, the need for the skills is universal here, just as it is in USA. In Nepal, ACLS training is needed by everyone who works in an Emergency Room or any kind of critical situation. Not just doctors either, but nurses too. Right now, a coordinated effort needs to be made to share this set of skills as widely as possible in Nepal.
If you are thinking of someday taking USMLE you will find that ACLS is indispensable. The items tested in ACLS are considered to be among the core knowledge for any doctor in USA. There are rumors that Nepal MBBS graduates are not ranked as highly as they could be, because they don’t have this training when they apply for residencies in India or abroad countries. They are unfairly penalized.
There are two resources of which you should be aware.
First, CCNEPal is a group that teaches a version of the ACLS class which does not lead to the official certificate. CCNEPal has trained 1,100 nurses and doctors since 2011. CCNEPal will be scheduling more courses in the near future. CCNEPal is also looking for docs who wish to help lead the training. You do not need to be a cardiologist!
Next, The Center for Medical Simulation (CMS) will soon be opening in Kathmandu. CMS will have a state-of-the-art Simulation learning center, including a “3G Sim Man” used for this type of training. Most importantly, CMS has applied to be designated an International Training Center via the American Heart Association, and will soon be offering high-quality training in ACLS that follows every standard of the Heart Association just as if you were taking an ACLS class in New York City. CMS will offer the full series of pre-course prep classes as well.
To find CMS, go to their FaceBook fan page. https://www.facebook.com/PrudentMeditechSimulationCenter
ACLS, and the skills it encompasses, needs to be taught in every medical school and nursing school in Nepal. ACLS is not simply a sit-down-and-take-notes class; it involves simulated patient situations that teach you how to react and save a life. ACLS gives assessment skills and teamwork skills that apply to a wide variety of situations.
for more information, or to volunteer in the effort to make ACLS more widely available to MBBS docs in Nepal, send an email to firstname.lastname@example.org